Export information: Country of destination: _________________________ Volume / Quantity: ___________________ Product/Formulation information: _________________ Country of destination: _________________________ Volume / Quantity: ___________________ Product/Formulation information: _________________ Applied and planned administrative and other control measures to prevent illegal production (e.g. specific permit system, recording of production): ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Applied and planned administrative and other control measures to eliminate or reduce releases of the substances and other POPs (e.g. specific permit system): ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Other measures that will be taken during the exemption period to limit the risks to health and the environment: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Información para solicitudes relativas al uso (se proporcionará información para todos los usos previstos): Usos para los que se solicita la exención: __________________________________________________ Nombre de la(s) empresa(s) / institución(instituciones) autorizadas para usar la sustancia: __________________________________________________________________________________ __________________________________________________________________________________ Cantidad prevista (kg/año): ____________________________________________________________ País de origen: ______________________________________________________________________ Origen y calidad de la sustancia o producto formulado (p.ej.